My Blog
By Emanuel Kontos, DMD
October 27, 2020
Category: Dental Procedures
Tags: celebrity smiles   veneers  
HowVeneersRestoredHowieMandelsWinningSmile

You probably wouldn't be surprised to hear that someone playing hockey, racing motocross or duking it out in an ultimate fighter match had a tooth knocked out. But acting in a movie? That's exactly what happened to Howie Mandel, well-known comedian and host of TV's America's Got Talent and Deal or No Deal. And not just any tooth, but one of his upper front teeth—with the other one heavily damaged in the process.

The accident occurred during the 1987 filming of Walk Like a Man in which Mandel played a young man raised by wolves. In one scene, a co-star was supposed to yank a bone from Howie's mouth. The actor, however, pulled the bone a second too early while Howie still had it clamped between his teeth. Mandel says you can see the tooth fly out of his mouth in the movie.

But trooper that he is, Mandel immediately had two crowns placed to restore the damaged teeth and went back to filming. The restoration was a good one, and all was well with his smile for the next few decades.

Until, that is, he began to notice a peculiar discoloration pattern. Years of coffee drinking had stained his other natural teeth, but not the two prosthetic (“false”) crowns in the middle of his smile. The two crowns, bright as ever, stuck out prominently from the rest of his teeth, giving him a distinctive look: “I looked like Bugs Bunny,” Mandel told Dear Doctor—Dentistry & Oral Health magazine.

His dentist, though, had a solution: dental veneers. These thin wafers of porcelain are bonded to the front of teeth to mask slight imperfections like chipping, gaps or discoloration. Veneers are popular way to get an updated and more attractive smile. Each veneer is custom-shaped and color-matched to the individual tooth so that it blends seamlessly with the rest of the teeth.

One caveat, though: most veneers can look bulky if placed directly on the teeth. To accommodate this, traditional veneers require that some of the enamel be removed from your tooth so that the veneer does not add bulk when it is placed over the front-facing side of your tooth. This permanently alters the tooth and requires it have a restoration from then on.

In many instances, however, a “minimal prep” or “no-prep” veneer may be possible, where, as the names suggest, very little or even none of the tooth's surface needs to be reduced before the veneer is placed. The type of veneer that is recommended for you will depend on the condition of your enamel and the particular flaw you wish to correct.

Many dental patients opt for veneers because they can be used in a variety of cosmetic situations, including upgrades to previous dental work as Howie Mandel experienced. So if slight imperfections are putting a damper on your smile, veneers could be the answer.

If you would like more information about veneers and other cosmetic dental enhancements, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Porcelain Veneers” and “Porcelain Dental Crowns.”

By Emanuel Kontos, DMD
October 17, 2020
Category: Dental Procedures
Tags: dental implants  
ImplantsCanMakeItEasiertoRestoreMissingTeethinStages

A fair number of people with total tooth loss have arrived at this point after a long history of dental issues. It's quite likely they've had a series of bridges or partial dentures over the years to accommodate lost teeth at various times before moving to full dentures.

For many, it often seems easier to extract any remaining teeth at some point and simply move on to a total restoration. It's often better for oral health, however, to preserve any remaining teeth for as long as possible and update restorations as needed. Dental implants could make this type of staged restoration strategy much easier to manage.

Implants are tiny metal posts surgically imbedded in a patient's jawbone. Over time, bone cells grow and adhere to the implant's titanium surface, creating a strong and durable hold. Its most familiar application is as a replacement for an individual tooth.

But because of their strength and durability, this advanced dental technology is also used to support other restorations like bridges and partial or full dentures by way of a few strategically placed implants. And it's in that role that they can be useful in planning and implementing future restoration upgrades when needed.

Under this strategy, we add implants to supplement pre-existing implants from earlier restorations to support the updated dental work. For example, we might have previously placed an implant supporting a single tooth or a small bridge. When the need later arises for a partial denture, we can add additional implants to be used with the earlier one to support the new denture.

If the earlier implants have been well-placed, we need only to add enough implants necessary to support a full denture when the time comes. How many will depend on the particular type of denture: A removable lower denture may only require one additional implant with one already in place. A fixed upper or lower denture will require enough to bring the number to between four and eight.

Taking this long-term approach can be more cost-effective in the long-run. More importantly, it can make for a smoother path for the patient and help preserve remaining teeth for as long as possible.

If you would like more information on restoration options for lost teeth, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Replacing All Teeth but Not All at Once.”

ProtectYourselfFromGumDiseasefortheHealthofYourMouthANDYourBody

October is National Dental Hygiene Month, when we call attention to the importance of keeping those pearly whites clean. Brushing and flossing, along with regular dental cleanings, protect your teeth and gums from dental disease. It might also lessen the risk or severity of heart disease, arthritis—or even dementia or Alzheimer's disease.

Sound far-fetched? A number of years ago, researchers noticed that people with periodontal (gum) disease were also more prone to systemic conditions like chronic heart and lung diseases, diabetes or rheumatoid arthritis. The common thread: inflammation, the body's response to infection or trauma.

Inflammation in and of itself is a necessary part of the healing process. But if it becomes chronic, as it often does with a gum infection and these other systemic diseases, this defensive response meant to aid healing can instead damage tissues.

We've also learned that inflammation arising from gum disease may worsen inflammation associated with other systemic conditions. It can work the other way as well: If you have an inflammatory disease, your risk for gum disease goes up and any gum infection can be more acute.

What we've learned recently, though, might be even more concerning: Results from a recent study are showing some evidence of a link between gum disease and dementia and decline in cognitive ability. The study, published in the journal Neurology this past July, followed approximately 8,000 Americans for twenty years. Participants came from a variety of locations and demographic subsets, and were on average in their early sixties with no signs of dementia at the beginning of the study.

Of the participants who completed the study, about 19% had developed dementia. Of these participants, those with severe gum disease and tooth loss were slightly more likely to have dementia than subjects with healthy teeth and gums.

At the very least, these studies raise more questions about the connections between oral and general health, calling for further exploration. One thing's for sure, though—healthy teeth and gums play an important role in the overall quality of life and health. The time and effort required for the following are well worth it to maintain a healthy mouth.

  1. Brush and floss your teeth every day without fail;
  2. Visit your dentist at least twice a year for professional cleanings;
  3. Eat a “tooth-friendly” diet low in sugar and rich in vitamins and minerals (especially calcium);
  4. See your dentist as soon as possible if you notice swollen, reddened or bleeding gums.

We all want to stay fit and active throughout our senior years. Taking care of your teeth and gums—especially with daily oral hygiene—is a key part of the formula for a long and happy life.

If you would like more information about the importance of dental hygiene to overall health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “10 Tips for Daily Oral Care at Home.”

By Emanuel Kontos, DMD
September 27, 2020
Category: Oral Health
Tags: oral health  
WanttoImproveYourAthleticPerformanceTryTuningUpYourDentalCare

After a long hiatus, school athletes are gearing up for another sports year. Given the pandemic, they may be modifying some of their usual habits and practices. But one thing probably won't change: These young athletes will be looking for every way possible to improve their sports performance. And a new research study offers one possible, and surprising, avenue—beefing up their oral hygiene practice.

That's the conclusion of the study published in BMJ Open Sport & Exercise Medicine, a sister publication of the British Journal of Sports Medicine. Working with a group of about 60 elite athletes, a research group in the U.K. found that improving oral health through better hygiene practices might also boost overall sports performance.

Because there's some evidence that over 50% of athletes have some form of tooth decay or gum disease, the study's researchers wanted to know if there was a link between athletes' sports performance and their dental problems caused by neglected oral hygiene. And if so, they wanted to see if better hygiene might improve sports performance as well as oral health.

Their first step was to establish an initial baseline for the participants with an oral health screening, finding that only around 1 in 10 of the study's participants regularly brushed with fluoride toothpaste or flossed. They then administered a detailed questionnaire developed by the Oslo Sports Trauma Research Center (OSTRC) to gauge the athletes' perception of how their current oral health affected their sports performance.

After some basic hygiene training, the athletes were given kits containing a toothbrush, prescription fluoride toothpaste and floss picks. They were then instructed to clean their teeth twice a day. Four months later, researchers found the number of participants who regularly brushed increased to 80%, and flossing more than doubled. What's more, a second OSTRC questionnaire found significant improvement overall in the athletes' perception of their sports performance.

As scientific research, these findings still need further testing and validation. But the study does raise the possibility that proper dental care could benefit other areas of your life, including sports participation.

Athlete or not, instituting some basic dental care can make a big difference in maintaining a healthy mouth:

  • Brush twice and floss once every day to remove accumulated dental plaque, the main source of dental disease;
  • Get a professional dental cleaning at least twice a year to remove stubborn plaque and tartar;
  • See us if you notice tooth pain or swollen or bleeding gums to stay ahead of developing dental disease.

Improving your dental care just might benefit other areas of your life, perhaps even athletic pursuits. We guarantee it will make a healthy difference for your teeth and gums.

If you would like more information on how you can improve your dental health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Daily Oral Hygiene.”

By Emanuel Kontos, DMD
September 17, 2020
Category: Oral Health
DontEatMotorizedCornontheCobandOtherDentalSafetyTips

We're all tempted occasionally to use our teeth in ways that might risk damage. Hopefully, though, you've never considered anything close to what singer, songwriter and now social media persona Jason Derulo recently tried in a TikTok video—attempting to eat corn on the cob spinning on a power drill. The end result seemed to be a couple of broken front teeth, although many of his followers suspected an elaborate prank.

Prank or not, subjecting your teeth to “motorized corn”—or a host of other less extreme actions or habits—is not a good thing, especially if you have veneers, crowns or other dental work. Although teeth can withstand a lot, they're not invincible.

Here, then, are four things you should do to help ensure your teeth stay healthy, functional and intact.

Clean your teeth daily. Strong teeth are healthy teeth, so you want to do all you can to prevent tooth decay or gum disease. Besides semi-annual dental cleanings, the most important thing you can do is to brush and floss your teeth daily. These hygiene tasks help remove dental plaque, a thin biofilm that is the biggest culprit in dental disease that could weaken teeth and make them more susceptible to injury.

Avoid biting on hard objects. Teeth's primary purpose is to break down food for digestion, not to break open nuts or perform similar tasks. You should also avoid habitual chewing on hard objects like pencils, nails or ice to relieve stress. And, you may need to be careful eating apples or other foods with hard surfaces if you have veneers or composite bonding on your teeth.

Wear a sports mouthguard. If you or a family member are regularly involved with sports like basketball, baseball/softball or football (even informally), you can protect your teeth from facial blows by wearing an athletic mouthguard. Although you can obtain a retail variety in most stores selling sporting goods, a custom-made guard by a dentist offers the best protection and comfort.

Visit your dentist regularly. As mentioned before, semi-annual dental cleanings help remove hidden plaque and tartar and further minimize your risk of disease. Regular dental visits also give us a chance to examine your mouth for any signs of decay or gum disease, and to check on your dental health overall. Optimizing your dental health plays a key part in preventing dental damage.

You should expect an unpleasant outcome involving your teeth with power tools. But a lot less could still damage them: To fully protect your dental health, be sure you practice daily oral care, avoid tooth contact with hard objects and wear a mouthguard for high-risk physical activities.

If you would like more information on caring for your cosmetic dental work, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Porcelain Veneers” and “An Introduction to Sports Injuries & Dentistry.”





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